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Individual

MR. FLAVIO F. SALAZAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LISW

Contact information

Practice address
1235 8TH ST, LAS VEGAS, NM 87701-4219
(505) 425-6788
(505) 425-5408
Mailing address
24B WINDSPIRIT RD, SANTA FE, NM 87505-1442
(505) 466-2747

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
I-07565
NM
207Q00000X
Family Medicine Physician
Primary
CNP-03287
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04236372
NM
Enumeration date
07/28/2009
Last updated
07/21/2022
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